Public-Involvement-Award-2015.Pdf

NOMINATION FORM PUBLIC INVOLVEMENT AWARD (Member Group)

This award is presented to an ASCE Illinois Section member group of two or more individuals for volunteer efforts that have made a positive impact and overall contribution for the betterment of our world. The following criteria will be considered in the selection process:  Positive impact and significance of public involvement activities in such areas as local and national legislation, improvement to the public welfare, education at all levels, non- profit volunteer organizations, community activities, etc.  Identify the number of people influenced by the activity.  Originality of activities.  Level of effort and time commitment of the group membership.

Submittal Requirements:

1. A completed nomination form (this form). 2. A nomination letter, no greater than four (4) pages, supporting the criteria listed on the front page of this form. Facts presented should include a description of the ASCE member group’s public involvement activities, number of people influenced, originality, and the group’s level of effort and time commitment for each activity. Please identify the members of the group who participated in public involvement activities and briefly describe their level of effort. Letters of appreciation or other examples of public recognition deserving consideration should also be provided.

Please mail one (1) original and e-mail a PDF of the award application n o l a t er t h an JULY 28, 2017 to:

Patrick Lydon, P.E. Michels Foundations 1266 Orchard Road Montgomery, IL 60538 Phone: 630-423-0804 Email: [email protected] PUBLIC INVOLVEMENT AWARD NOMINATION FORM

ASCE Illinois Section Group: ____ Contact Person: ____ Title: ____

Mailing Address: ____

Phone: ___ Office Fax Email: ___ Approximate number of overall membership (if available) ___ Does the member group have a public involvement committee: Yes No (If yes, please list committee members)

NOMINATED BY:

Name: ____ Title: ____ Company: ____

Address: ____

Phone: ___

E-mail: ___ Signature: ______Date: ______